Dual Diagnosis: Attention Deficit Hyperactivity Disorder (ADHD) and Addiction

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Dual Diagnosis: ADHD and Addiction

There is deep overlap between ADHD (Attention-Deficit Hyperactivity Disorder) and addiction. People with ADHD are more than five times likelier to struggle with addiction. 20-40% of adults with ADHD have a history of substance abuse.

ADHD is among the biggest risk factors for addiction.

Finding strategies to regulate ADHD can be important in maintaining long-term sobriety. And this condition need not be a burden. To the contrary, when properly regulated, it entails an abundance of assets that can be fruitfully tapped.

What is ADHD?

ADHD is a mental health condition present in both children and adults.

It is rooted in the underproduction of two particular neurotransmitters in the brain- dopamine and norepinephrine. These neurotransmitters mediate our ability to focus.

Symptoms of ADHD include:

  • Distractibility

  • Impulsivity

  • Difficulty concentrating

  • Hyperfocus on one thing at the expense of others

  • Disorganisation

  • Disorganisation

  • Hyperactivity (more prevalent in children, less so in adults)

  • Trouble multitasking

  • Low frustration tolerance

  • Restlessness

Why do ADHD and addiction so commonly co-occur?

Substance abuse may be a conscious or unconscious attempt to self-medicate for ADHD. Drugs may initially serve to mitigate some of the symptoms, such as restlessness. Certain symptoms, such as impulsiveness and sensation-seeking, leave people more vulnerable to addiction.

Some of the consequences of neglected ADHD, such as underachievement, may lead to frustration and disappointment, which also create fertile conditions for substance abuse.

There is overlap between the neural-circuitry  tapped by addiction and that affected by ADHD; primarily the dopamine reward circuits.

ADHD can be a risk to recovery

Once you get clean, it’s important to regulate other conditions that could lead you back to drugs. If left unattended , some of the symptoms of ADHD could pose a threat to your recovery. Restlessness, impulsivity and low frustration tolerance pose particular challenges in the early days of recovery.

The potential benefits of ADHD

When channeled with the right support, ADHD can be an asset. Many of the so-called symptoms can actually be harnessed into special qualities. Distractibility morphs into curiosity, impulsiveness becomes creativity, and hyperactivity means abundant energy.

Many trailblazing entrepreneurs, creative geniuses and sportsmen have had ADHD, such as Richard Branson, Salvador Dali and Michael Phelps.

What can we do about it?

Besides medication, there are a number of behavioural strategies we can use to regulate some of the challenges presented by ADHD and to clear the way for the potential assets embedded in the condition to flourish.


Mindfulness meditation trains our ability to focus our attention. We learn to notice our mind wondering and to bring it back to the focus of the meditation when we get distracted. This helps foster greater self-awareness. When we are more aware of what is happening within, we are better able to regulate our behaviours and act in ways conducive to our goals.

Meditation strengthens the pre-frontal cortex which mediates executive functions such as emotional regulation, focusing, self-awareness and goal-oriented behaviour.


Exercise stimulates the release of neurotransmitters such as dopamine in the brain. These are the same neurotransmitters deficient in ADHD. Exercise helps improve concentration, focus and executive function. It also helps work off some of the hyperactive energy often associated with ADHD, steadying energy levels and fostering a sense of calm.

Even 30 minutes of gentle exercise four times a week can make a substantial difference.

Limit social media use

Studies have shown that high frequency social media use can generate ADHD symptoms in people who don’t even have the condition. For people who do, the impact of frequent social media use can be detrimental. It can compound ADHD symptoms such as distractability, and make it even harder to regulate and direct attention.

Social media taps the same dopamine reward circuits as substances, and as such can mimic their potentially compulsive and addictive nature. Turning off instant notifications can help avoid aggravating ADHD symptoms.


ADHD or addiction alone can be a recipe for chaos. When you combine the two the scope for chaos is even greater.

Building a strong routine and maintaining it with discipline can neutralise this chaos and create a solid platform that allows you to thrive. Once you nail the basics and stick to them for a while, they start to become habits. This frees up mental space and energy for creativity to flourish. A strong and steady routine means that, rather than being controlled by the potential blocks of ADHD, you nurture the assets of the condition.

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